Pilot Study of Topotecan/Vincristine With Subconjunctival Carboplatin for Patients With Bilateral Retinoblastoma

NCT00980551 | Withdrawn DMC

• 1 other identifier: RELRB1
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators are testing subtenon carboplatin in combination with vincristine and topotecan given by vein in the hopes of finding a drug combination that may be effective against retinoblastoma that has come back (recurrent) or is resistant to other treatment (refractory). The goals of this study are:

• To decide if the drug combination is a useful treatment for recurrent or refractory retinoblastoma
• To test the safety of the drug combination and to see what kind of effects (good and bad) can be expected from the drug combination
• To measure visual changes before and after the study therapy
• To use a special MRI scan to measure brain function involved in vision processing, both before and after the study therapy In this study, the investigators are also testing a new experimental way of giving carboplatin "subtenon carboplatin". The carboplatin will be given directly in the eye through a needle placed under the covering of the eye. This is to try to get more carboplatin to the retinoblastoma inside the eye.

Conditions

Retinoblastoma

Outcome Measures

Primary Outcomes (2)

• To estimate the event-free survival, where an event is defined at the ocular level as the need for non-protocol therapy defined as additional non-protocol chemotherapy, external beam radiation, or enucleation.

  at 1 year

• To estimate the patterns of response, and response rate of locally refractory retinoblastoma to combination intravenous and peri-ocular chemotherapy.

  at 1 yr

Secondary Outcomes (4)

• To describe the toxicities associated with the proposed regimen.

  at 1 yr

• To describe the histologic findings in the eyes ultimately requiring enucleation.

  at 1 yr

• To describe the visual acuity of patients with advanced intraocular retinoblastoma before and after the proposed therapy.

  at 1 yr

• To describe primary visual cortex function in patients with retinoblastoma via functional Magnetic Resonance Imaging (fMRI) technique both before and after the proposed therapy.

  at 1 yr

Study Arms (1)

Topotecan/Vincristine with subtenon Carboplatin

EXPERIMENTAL

Drug: subtenon Carboplatin; Drug: Topotecan Hydrochloride; Drug: Vincristine; Drug: Filgrastim

Interventions

subtenon Carboplatin DRUG

Available in 50mg, 150mg, 450 mg, 600mg vials. It is provided as a premixed aqueous solution or lyophilized powder for injection given on day 1/week 10 (cycles 1-3).

Also known as: Paraplatin

Topotecan/Vincristine with subtenon Carboplatin

Topotecan Hydrochloride DRUG

Each vial contains topotecan hydrochloride equivalent to 4 mg of topotecan as free base. Given intravenously on days 1-5 of each week (cycles 1-6).

Also known as: Hycamtin

Topotecan/Vincristine with subtenon Carboplatin

Vincristine DRUG

Each vial contains vincristine sulfate, 1 mg; mannitol, 100 mg; sterile water for injection; Acetic acid and sodium acetate are added for pH control. Given intravenously on day 1/week 1 (cycles 1-6).

Also known as: Oncovin

Topotecan/Vincristine with subtenon Carboplatin

Filgrastim DRUG

Supplied as a clear solution in 300 mcg/ml 1 ml or 1.6 ml vials and prefilled syringes containing 300mcg/0.5mL or 480mcg/0.8mL. Given intravenously on day 6 of each week (cycles 1-6).

Also known as: Neupogen

Topotecan/Vincristine with subtenon Carboplatin

Eligibility Criteria

• Age: Up to 10 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Age: ≤ 10 years of age
• Diagnosis: Patients must have a history of bilateral Retinoblastoma AND Recurrent/Refractory Intra-Ocular Retinoblastoma considered not amenable to cure with local therapies alone (photocoagulation with argon laser, cryotherapy, transpupillary thermotherapy, radioactive plaque therapy).
• Therapeutic Options: Patient's disease status is one for which there are no known options proven to provide a high chance for ocular salvage or cure other than external beam radiation or enucleation.
• Remaining visual function in target eye (s) is required
• Life Expectancy of \> 8 weeks
• Lansky ≥ 50
• Prior Therapy: Patients must have local relapsed/refractory disease after receiving standard upfront therapy involving at least one chemotherapeutic regimen. There is no limit to prior chemotherapeutic regimens permitted. Patients may have received previous intravenous carboplatin, but may not have received prior subtenon carboplatin or intravenous topotecan.
• Patients must have recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study, as described below:
• Myelosuppressive chemotherapy: patients must not have received myelosuppressive chemotherapy within 3 weeks of study enrollment
• Biologic therapies: Patients must not have received biologic anti-cancer agents within one week of study enrollment
• Radiation therapy: Four weeks must have elapsed since external beam radiation therapy, if given.
• Adequate Bone Marrow Function Defined as:
• Peripheral absolute neutrophil count (ANC) ≥ 750/µL
• Platelet count ≥ 75,000/µL (transfusion independent, defined as not receiving platelet transfusions within a 7-day period prior to enrollment)
• Hemoglobin ≥ 8.0 gm/dL (may receive RBC transfusions)

You may not qualify if:

• Extra-ocular retinoblastoma
• Asynchronous involvement of the contralateral eye, previously untreated
• Uncontrolled infection at time of protocol entry
• Concomitant Medications:
• Growth factors that support platelet or white cell number or function must not have been administered within the past 3 days
• Patients who are currently receiving investigational drugs, or who have received an investigational drug within the last 7 days, are ineligible
• Patients who are currently receiving other anti-cancer agents are ineligible
• Patients who in the opinion of the investigator may not be able to comply with the safety monitoring requirements of the study are not eligible

Sponsors & Collaborators

• Children's Hospital Medical Center, Cincinnati: lead

Study Sites (1)

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, 45229, United States

Location

MeSH Terms

Conditions

Retinoblastoma

Interventions

Carboplatin; Topotecan; Vincristine; Filgrastim

Condition Hierarchy (Ancestors)

Neoplasms, Neuroepithelial; Neuroectodermal Tumors; Neoplasms, Germ Cell and Embryonal; Neoplasms by Histologic Type; Neoplasms; Neoplasms, Glandular and Epithelial; Neoplasms, Nerve Tissue; Retinal Neoplasms; Eye Neoplasms; Neoplasms by Site; Eye Diseases, Hereditary; Eye Diseases; Retinal Diseases

Intervention Hierarchy (Ancestors)

Coordination Complexes; Organic Chemicals; Camptothecin; Alkaloids; Heterocyclic Compounds; Vinca Alkaloids; Secologanin Tryptamine Alkaloids; Indole Alkaloids; Indoles; Heterocyclic Compounds, 2-Ring; Heterocyclic Compounds, Fused-Ring; Indolizidines; Indolizines; Granulocyte Colony-Stimulating Factor; Colony-Stimulating Factors; Glycoproteins; Glycoconjugates; Carbohydrates; Hematopoietic Cell Growth Factors; Cytokines; Intercellular Signaling Peptides and Proteins; Peptides; Amino Acids, Peptides, and Proteins; Proteins; Biological Factors

Study Officials

• James Geller, MD

  Children's Hospital Medical Center, Cincinnati

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 18, 2009
• First Posted: September 21, 2009
• Study Start: May 1, 2010
• Primary Completion: March 1, 2012
• Study Completion: March 1, 2012
• Last Updated: March 3, 2017

Record last verified: 2017-02

Locations

US (1)